Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dental Depot South

Organization General Practice Dentistry · NPI 1578768180

Dental Depot South is a General Practice Dentistry in Oklahoma City, Oklahoma. Registered with an NPI since 2007.

In the registry since
2007

Practice location Address checks out

1024 SW 104th St
Oklahoma City, OK 73139-2990
Phone: (405) 691-1123
Fax: (405) 691-2674
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X

Record details

NPI number1578768180
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gaylon Zissa — Director Provider Relations · (405) 691-1123
NPI enumeratedJune 15, 2007
Last updated in NPPESJune 25, 2021
Certification dateJune 25, 2021
Mailing address2828 Nw 30th St, Oklahoma City, OK 73112-7404

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